Healthcare Provider Details

I. General information

NPI: 1043878705
Provider Name (Legal Business Name): DORTHEA LORINE WHEELER MD, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2019
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5249 E TERRACE DR
MADISON WI
53718-8339
US

IV. Provider business mailing address

1265 JOHN Q HAMMONS DR
MADISON WI
53717-1921
US

V. Phone/Fax

Practice location:
  • Phone: 608-251-4156
  • Fax:
Mailing address:
  • Phone: 608-251-4156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number87756-20
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberR-11583
License Number StateIA
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD-50216
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: